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Giving life

Raymond Rocke, whose wife Leah died and had her organs transplanted. Her coma, and subsequent death shattered his family.

Photograph by: Peter Battistoni/Vancouver Sun
, Vancouver Sun

VANCOUVER — When Raymond Rocke’s wife Leah died just days after giving birth to their daughter, he knew even in his pain and confusion what to do. Leah, his bride of less than one year, had taught him how to give.

Heart, lungs, liver, life itself for someone. So he gave what he and Leah had to give.

People who receive organ transplants feel an inexpressible gratitude for the gift they receive, to continue living. And most never know the giver.

But all of them live knowing that their lives continue at a terrible cost, usually the life of their donor. When a person dies and the circumstances are right — healthy organs are available that match the needs of people who may just hours from death themselves — a grieving family must often make a decision to allow doctors to collect the organs of their just-departed loved one.

Raymond and Leah were just starting their lives together. They met in Toronto in 1997 and Raymond was struck right away by Leah’s beauty and her kindness. He approached her and they hit it off. Originally from the Philippines, Leah, then 31, was working as a nanny and brought the three children that she cared for on their first date.

Shy and still smarting from a failed marriage, Raymond courted her gently. Sometimes he would get off the bus at a stop where he could “accidentally run into her.” Anything to talk to her.

Raymond worked by day and attended school at night, but stayed as close as possible to Leah and talked to her about the future.

Over time they fell in love.

“She was very patient with me,” he said. “Very generous.”

When Raymond was offered a job in Vancouver, he asked Leah to come with him and she did. They married in Vancouver late in 2002 and one month later she was pregnant.

“She was so excited,” he said. “She just loved children.”

Raymond was checking off the boxes on his To-Do List at a furious pace: get a job, get married, have a child. But you can’t plan for everything.

Leah gave birth to their daughter Tizjana, now four, by Caesarean section after a lengthy, difficult labour. They brought Tizjana home to their West End apartment a few days later.

“I kissed her good night Wednesday evening and said ‘I’ll see you when the baby wakes us,'" Raymond recalled. But Thursday morning something was wrong. Leah was incoherent and unable to speak clearly.

Raymond called an ambulance. A crew came but opted not to take Leah to St. Paul’s Hospital, which was only a few blocks away.

“They said she was exhausted and to let her rest,” so he did. The next day she was no better.Another ambulance was called and this time they took Leah to the hospital.

“I was so relieved, I thought now she will start to get better,” he said. Leah got worse, slipping into a coma. She had bled into her brain.

After a week of decline in Leah’s condition, the doctor called Raymond to the hospital and told him Leah would die within hours.

“I watched the machines keeping her alive and prayed over her and they declared her dead,” he said. When she was gone Raymond sat asking God for an explanation.

“That was when the nurse came and asked if I would consent to giving her organs,” he said. “That was when it really sunk in, that she was gone.”

“I knew that I couldn’t change the outcome here, but that she could help someplace else,” he said. “So I said goodbye.”

Weeks later, Raymond learned how much Leah had helped. A letter from the B.C. Transplant Society listed the organs that had been transplanted: heart, lungs, liver, corneas.

Many organ recipients write thank-you letters to the families of their donors, which are delivered through the B.C. Transplant Society. No identifying information is allowed. Donor families sometimes even write back, also anonymously, but for both sides the process is fraught with emotion. Often guilt and grieving make communication difficult.

There are times when donors and recipients mingle.

Each year in October, the B.C. Transplant Society hosts a medal ceremony in which donor families are awarded a medal in the name of their loved one. Ceremony aside, it is often enough for donor families to see healthy normal lives carrying on in the form of organ-transplant recipients who attend and speak at the event.

“You get to meet other people who have been through what you have been through and meet people who have been helped,” Raymond said. “Some of the recipients are 19, 20 years old. I met a grandfather who had a couple of days left in his life and who now can play with his grandchildren.”Raymond isn’t looking for thank-yous. It’s more about moving on with life.

“I just want to see how they are doing and that they are healthy,” he said. “I like to know that life is going on.”

More than 25,000 people die each year in British Columbia and fewer than one per cent are good candidates for organ donation. In 2006, 264 successful organ transplants took place.

“To be a solid organ donor you have to die a brain death; the person has to be on a breathing machine and they have to die in hospital,” said Lisa Despins, spokeswoman for the B.C. Transplant Society.

Hospital staff keep the society apprised of potential donors, which dispatches an organ-donation specialist to talk to the family and obtain consent if it has not been given. If a healthcare worker is close to the family, that person may make the first contact and offer them the opportunity to donate.If a consent form was signed by the potential donor, the organ donation specialist will bring it and approach the family to explain the process.

“It is usually a huge relief for the family,” said Despins. “It’s there in black and white and they don’t have to make that decision.”

An extensive medical history is be obtained from the family by the organ-donation specialist to determine which organs can be used, according to the director of organ donation for the B.C. Transplant Society, Penny Richardson.

“Sometimes an obscure disease or condition will make organs unusable,” she explained. The organs that are healthy are matched for size — especially hearts and lungs, which cannot be forced into a smaller space — and blood type with people on the waiting lists. No organ is ever removed that does not a have a recipient identified and waiting for it.

The specialist will stay with the donor through removal, package the organs, transport them and deliver then to B.C.’s three transplant centres at Children’s Hospital, Vancouver General and St. Paul’s.

Often kidneys and lungs, because there are two of each, are sent to separate recipients. Optimal distribution of organs from a single donor can save seven lives, Richardson said.

Consent forms are available in doctor’s offices, London Drugs and online at transplant.bc.ca.Once the form is mailed or faxed in, the information is added to the society’s database. More than 635,000 people have registered and that sounds like a lot. But that is only 14 per cent of the population, and the wait times for most major organs range from four or five months for a liver to 80 months for a kidney — a long time when a person is critically ill.

“If you take five minutes to fill out the form — either way, you can say yes or no — you never have to think about it again,” Despins said.